Provider Demographics
NPI:1083345011
Name:PEREZ, TRISTIEN CELINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:TRISTIEN
Middle Name:CELINE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 788
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:12758-0788
Mailing Address - Country:US
Mailing Address - Phone:845-797-5232
Mailing Address - Fax:
Practice Address - Street 1:9114 MERRICK BLVD STE 3
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5363
Practice Address - Country:US
Practice Address - Phone:718-206-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty